Edward Phillip Kiss, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6169 Issued in WA

Practice address

5012 58TH Avenue CT W
University Place, WA 98467-3689

Phone

(253) 566-0456

NPI assigned

Apr 10, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 15, 2016 through Dec 15, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jordan Priess DDS PLLC

  • Dental Clinic/Center
  • Gig Harbor, WA
  • NPI 1659210896
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1598938458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14315 62ND AVE NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983328664",
            "telephone_number": "253-851-4025",
            "fax_number": "253-853-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 58TH AVENUE CT W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984673689",
            "telephone_number": "253-566-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISS",
        "first_name": "EDWARD",
        "middle_name": "PHILLIP",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minah Kim, MT
• You-Ree Kim
• Lisa Ann Kingsley, LMP
• David Kinyua
• Caitlyn Kirkland
• Delaney Nicole Kissel
• Amber Kliewer, MA
• Yana Klymok, RN
• Alexander Knapp, DPT
• Harry Burton Knaster, M.D.

• General Practice Dentistry in University Place, WA
• Providers in University Place, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.